Tolerance and toxicity of primary radiation therapy in the management of seropositive HIV patients with squamous cell carcinoma of the head and neck

Waleed F. Mourad, Kenneth S. Hu, Dan Ishihara, Rania A. Shourbaji, Wilson Lin, Mahesh Kumar, Adam S. Jacobson, Theresa Tran, Spiros Manolidis, Mark Urken, Mark Persky, Louis Harrison

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objectives/Hypothesis To report tolerance and toxicity of radiotherapy (RT) with or without chemotherapy in HIV seropositive patients with squamous cell carcinoma of the head and neck (SCCHN). Methods This is a single institution retrospective study of 73 HIV seropositive patients with SCCHN treated from January 1997 through 2010. Stages I, II, III, and IV were 8%, 10%, 24%, and 58%, respectively. The median age at RT, HIV diagnosis. and the duration of HIV seropositive were 51 (32-72), 34 (25-50), and 11 (6-20) years, respectively. Patients were treated definitively with RT alone (35%) or concurrent chemo-RT (65%). Median dose of 70 Gy (66-70) was delivered to the gross disease. Median duration of treatment was 52 (49-64) days. Fifty patients (70%) were on HAART. Results RT± chemotherapy induced acute toxicity was: median weight loss 20 pounds (6-40), 100% developed dysgeusia and xerostomia (grades 1-3). Acute mucositis and dysphagia/odynophagia grades ≤2 and 3 were 83% and 17%, respectively. Treatment breaks in excess of 10, 7, and 3 days were found in 5%, 13%, and 15% of patients, respectively. With a median follow-up of 4 years (2-12) the RT ±chemotherapy induced late dysphagia and xerostomia grades >2 were 26% and 23% of patients, respectively. Conclusion Our data show that primary RT ±chemotherapy for HIV seropositive SCCHN is less tolerated compared to the historical data for SCCHN without HIV.

Original languageEnglish (US)
Pages (from-to)1178-1183
Number of pages6
JournalLaryngoscope
Volume123
Issue number5
DOIs
StatePublished - May 2013

Keywords

  • CD4
  • HAART
  • HIV
  • IMRT
  • Tolerance and toxicity
  • chemotherapy
  • radiotherapy
  • squamous cell carcinoma of the head and neck

ASJC Scopus subject areas

  • Otorhinolaryngology

Fingerprint Dive into the research topics of 'Tolerance and toxicity of primary radiation therapy in the management of seropositive HIV patients with squamous cell carcinoma of the head and neck'. Together they form a unique fingerprint.

Cite this